Alcoholism is frequently associated with aggressive behaviors, smoking and dietary changes/deficiencies. To explore facets of each of these common co-morbidities, we have initiated several clinical research studies designed to explore their association with the pathophysiology of alcoholism. It has been shown that there is a strong association between alcohol consumption and violent behavior, however, the actual mechanism(s) by which alcohol induces aggressive behavior is poorly understood. During the past year, we developed a research initiative to explore the association between violence and alcoholism in a select patient population characterized by frequent episodes of domestic violence. We hope to determine if treatment with a serotonin reuptake inhibitor can produce a significant improvement on standardized measures used to quantify aggression in this select patient population. Another aspect of our research is related to smoking cessation in recently detoxified alcoholics. It is estimated that 60-70% of individuals with the diagnosis of alcoholism are also dependent on tobacco products. This apparent link between nicotine dependence and alcoholism is reinforced by studies showing a positive correlation between alcohol ingestion and increased smoking, yet it is unclear what role smoking plays in the pathophysiology of alcoholism. To explore this interaction, we are analyzing previously collected CSF metabolite data obtained from smoking and non-smoking alcoholics shortly after their admission to the hospital and during the course of their alcohol/smoking withdrawal. It is anticipated that these results will provide insights into why alcoholics smoke and resist smoking cessation. Sober alcoholics frequently report that they binge on sweets to decrease their desire to drink alcohol. This exaggerated desire for sweets has contributed to the postulate that alcohol consumption is regulated by the same mechanisms that regulate the intake of carbohydrates. To explore this postulate we examined the effects of glucoprivation on hypothalamic function and carbohydrate consumption in long-term sober alcoholics. During this year we have shown (Alcohol Clin Exp Res 25:781-786, 2001) that the disturbances in hypothamic function previously reported in three-week sober alcoholics are not present in long-term recovering alcoholics. Findings of two additional studies are currently being prepared for publication. One paper compares the relationship between CSF monoamines and plasma glucose in alcoholics and controls. The second examines carbohydrate consumption in alcoholics at rest and following metabolic stress. Alcoholics frequently have disturbances in nutritional intake that may contribute to changes in mood (i.e., depression and hostility) as well as cognition. One possible nutrient that has been implicated in both of these clinical states is docosahexaenoic acid (DHA). Since chronic alcohol intake depletes DHA from the brain, we designed a study that would allow us to quantify and image the uptake of DHA in the brains of recently detoxified alcoholics and healthy controls. This study is important because there is no methodology currently available that will allow us to assess DHA metabolism in the human brain.